Individual
DEBORAH JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2212 DEVINE ST STE D, COLUMBIA, SC 29205-2402
(803) 206-7024
Mailing address
2212 DEVINE ST STE D, COLUMBIA, SC 29205-2402
(803) 206-7024
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
5493
SC
Other
Enumeration date
07/06/2016
Last updated
07/06/2016
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